Oral communication, iL47

Official XXIst International Pigment Cell Conference website - 21-24 Sept 2011, Bordeaux - France | updated: September 04 2011

Treatment guideline in segmental vitiligo

Vitiligo is classified into segmental and nonsegmental type. Each type has a different clinical feature and natural history. Segmental vitiligo often starts early in life. It is almost always limited to one segment of the body and does not go over the opposite side of the body. It tends to spread rapidly and be stabilized in a few years. Thus, the course of segmental vitiligo is predictable while that of nonsegmental vitiligo is unpredictable. White hairs seem to be always associated with segmental vitiligo. The preferential management for segmental vitiligo includes topical corticosteroids and immunomodulators, and phototherapy such as narrow-band UVB and excimer laser. If medical treatments are unsatisfactory, surgical treatment such as epidermal grafting can be considered. Recently, the treatment guideline for vitiligo was reported, but it has some limitations. Here, based on the previous reports and our experiences we propose a treatment guideline in segmental vitiligo. Recently we reported that medical treatments were not helpful in long-duration segmental vitiligo, demonstrating that disease duration is very important for the responsiveness of medical treatment. Thus, as a first line we recommend combination of topical therapy and phototherapy as soon as possible. In addition, we found that phototherapy was not helpful in the patients with segmental vitiligo who had the majority of white hairs in the lesional skin. Therefore, we recommend that if the majority of hairs are white in the lesional skin, as a first line surgical therapy is indicated to avoid unnecessary treatment and a waste of time instead of medical treatments. We expect that this guideline will provide definite decision for the treatment of segmental vitiligo.

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